sophie guellati-salcedo - april 2001 personality, coping styles and chronic pain toward a structural...

Sophie Guellati-Salcedo - April 2001

PERSONALITY,COPING STYLES

AND CHRONIC PAIN

Toward a structural approach to adjustment


Outline

1. Introduction

2. Goal

3. Definitions

4. Hypotheses

5. Sample and Measures

6. Results

7. Conclusion


• The Gate Control Theory Melzack & Wall (1965)

• Multidimensional model of pain 4 components :sensory-discriminative

affective-emotionalcognitivebehavioral

• Definition of the IASP

1.1. The biopsychosocial model of pain


• Trait State Model

(Cottraux & Blackburn, 1995)

• “Big Five” Model (Digman, 1990)

• The Five-Factor Theory

(McAdams, 1996; Costa & McCrae, 1999)

1.2. Models of Personality


• Dispositional vs. Situational approach

• Coping styles vs. Coping responses

• Regulating role vs. Outcomes

• Adjustment vs. Adaptation

1.3. Coping and correlates


• Structural approach

• Postulate: Regularities in behavior

• Type of relationship between variables

• A three-level hierarchical model

1.4. Model proposed


Outline

1. Introduction

2. Goal

3. Definitions

4. Hypotheses


6. Results

7. Conclusion


Answer this question:

Does taking into consideration usual patterns of cognition and behavior allow a better understanding of specific cognitive-behavioral responses to the experience of chronic pain ?

2. Goal


Outline

1. Introduction

2. Goal

3. Definitions

4. Hypotheses


6. Results

7. Conclusion


3. Definitions

A theoretical position constrains:

the definition of concepts

the operationalization of variables


3.1. Usual patterns of behavior

Three levels of patterns… : personality dimensions (Big Five) coping styles usual coping responses to pain

… characterized by :

temporal stability

cross-situational consistency


3.2. Components of adjustment

Sensory component of pain: Sensory / affective descriptors

Functional component: Impact on everyday life

Emotional component: Depressive / Anxious states


Outline

1. Introduction

2. Goal

3. Definitions

4. Hypotheses


6. Results

7. Conclusion


4.1. Main Hypothesis

Chronic pain patients adopt specific pain-related behaviors that depend on their personality traits and coping styles

The components of their adjustment to pain are related to their usual patterns of behavior


4.2. Operationalization

The relationship between usual patterns of behavior and specific pain-related adjustment responses differs according to the aspect of pain experience measured:

intensity and description of pain functional status (daily activities) emotional state (depression, anxiety)


Outline

1. Introduction

2. Goal

3. Definitions

4. Hypotheses


6. Results

7. Conclusion


5.1. Population and Sample

• Outpatients from a multidisciplinary pain clinic

• A specific category of pain patients

• An heterogeneous sample.

• Random diversity of pathologies

• Average duration of pain: 7.8 years


5.2. Measures of usual patterns of behavior

3 degrees of “predictors” :

Personality traits

Coping styles

Coping responses to pain

D5D

CISS

CSQ


5.3. Measures of pain adjustment

4 categories of “outcome variables”:

Intensity of pain

Description of pain

Functional impact

Emotional impact

VAS

QDSA

QUOTI7 MPI IIIBDI 13HAD


Outline

1. Introduction

2. Goal

3. Definitions

4. Hypotheses


6. Results

7. Conclusion


6.1. Proportions of variance explained

Sensory components : intensity of pain

21% description of pain 41%

Functional impact : daily activities 30% outdoor and social activities 44%

Emotional impact : Depressive state 53% Anxious state 52%


6.3. Prediction of pain intensity

D5D

CISS

CSQ 14%

21%

OverallModel

N.S.

D5D D5D

CISS

N.S.

n.s.

Proportion of variance explained


6.2. Partial Correlations

Variables Beta p-value Variables Beta p-value

Intensity CATAS +0,232 0,027of pain PRAY +0,238 0,022

STEM -0,270 0,005 EMO +0,388 0.000TASK -0,203 0,031 CATAS +0,352 0.000

CSCX +0,234 0,016

TASK +0,276 0,006

STEM +0,369 0,001 EMO -0,373 0,002EVIT +0,348 0.000 CATAS -0,308 0,004

REINT +0,240 0,033

STEM -0,301 0,001 EMO +0,580 0.000OPEN -0,192 0,043 CATAS +0,252 0,002TASK -0,163 0,049EVIT -0,241 0,001

SELFST -0,340 0,001

STEM -0,478 0.000 EMO +0,434 0.000OPEN -0,197 0,021 BEHAV +0,221 0,031

Better Adjustment Poorer Adjustment

Anxious State

Depressive State

Outdoor and Social

Activities

Household Chores

Affective Descriptors


6.4. Prediction of affective description of pain

D5D D5D

CISS

D5D

14%

CSQ 16%

41%

OverallModel

CISS

24%

11%



6.2. Partial Correlations




CSCX +0,234 0,016

TASK +0,276 0,006


REINT +0,240 0,033


SELFST -0,340 0,001



Anxious State

Depressive State

Outdoor and Social

Activities

Household Chores



6.5. Prediction of functional impact of pain

On everyday life

D5D D5D

CISS

D5D

N.S.

CSQ 2%

30%

OverallModel

CISS

14%

7%




On household chores

D5D D5D

CISS

D5D

N.S.

CSQ n.s.

20%

OverallModel

CISS

6%

6%



6.2. Partial correlations




CSCX +0,234 0,016

TASK +0,276 0,006


REINT +0,240 0,033


SELFST -0,340 0,001



Anxious State

Depressive State

Outdoor and Social

Activities

Household Chores




On outdoor and social activities

D5D D5D

CISS

D5D

15%

CSQ 14%

44%

OverallModel

CISS

31%

16%







CSCX +0,234 0,016

TASK +0,276 0,006


REINT +0,240 0,033


SELFST -0,340 0,001



Anxious State

Depressive State

Outdoor and Social

Activities

Household Chores



6.6. Prediction of emotional impact of pain

Depressive state (BDI 13)

D5D D5D

CISS

D5D

20%

CSQ 12%

53%

OverallModel

CISS

42%

22%







CSCX +0,234 0,016

TASK +0,276 0,006


REINT +0,240 0,033


SELFST -0,340 0,001



Anxious State

Depressive State

Outdoor and Social

Activities

Household Chores




Depressive state (HAD Depression)

D5D D5D

CISS

D5D

22%

CSQ 9%

49%

OverallModel

CISS

41%

19%




Anxious state (HAD Anxiety)

D5D D5D

CISS

D5D

35%

CSQ 7%

52%

OverallModel

CISS

45%

11%







CSCX +0,234 0,016

TASK +0,276 0,006


REINT +0,240 0,033


SELFST -0,340 0,001



Anxious State

Depressive State

Outdoor and Social

Activities

Household Chores



Outline

1. Introduction

2. Goal

3. Definitions

4. Hypotheses


6. Results

7. Conclusion


7. Conclusion

Usual patterns of behavior distal variables: personality proximal variables: coping

are significantly correlated with the components of pain adjustment

Different patterns of predictors with different aspects of adjustment


7. Conclusion Personality Dimensions

Neuroticism is associatedwith poorer adjustment to pain

Emotional stability, openness, and conscientiousness are associatedwith better adjustment to pain


7. Conclusion Coping Styles

Emotion-oriented coping is associated with poorer adjustment to pain

Task-oriented coping and avoidance are associated with better adjustment to pain


7. Conclusion Coping responses to pain

Catastrophizing, praying and hoping, and distraction are associated with poorer adjustment to pain

Coping self-statements and reinterpreting sensations are associated with better adjustment to pain

sophie guellati-salcedo - april 2001 personality, coping styles and chronic pain toward a structural...

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sophie guellatisalcedo

goal slide

adjustment slide

conclusion slide

model proposed slide

models of personality

multidimensional model

experience of chronic